Ruling Out an STI

As we have previously written, sexually transmitted infections are pretty widespread but sometimes the symptoms of a sexually transmitted infection can actually be something else – we call this a differential diagnosis. For example, a woman with an unusual vaginal discharge may suspect Gonorrhoea but it may in fact be Bacterial Vaginosis. It may even be cervical cancer. I have used this rather extreme diagnosis to illustrate the need for proper testing. With the advent of the internet, everyone thinks that they are a medical expert and can make a diagnosis but as the old adage goes, a little bit of knowledge is a dangerous thing!

As a doctor, it can be extremely frustrating when patients come to me and say that they have chlamydia or they have gonorrhoea and they can tell the difference because of the way the symptoms present because they have read this somewhere on the internet. The fact is that you cannot tell the difference between these infections from reported symptoms. Testing is easy and pretty quick these days so there is really no excuse not to test. I know that if you use the NHS then you might have to wait a week or so for results but there are low cost alternatives and, quite frankly, if you can afford to pay a little bit then why not – it also has the advantage of taking a bit of pressure off the NHS, which is creaking at the edges because of new demands.

If a patient approaches me with symptoms then of course I use those symptoms to decide what tests to request from our lab but I would never make a sexual health diagnosis without following it up with lab tests for confirmation. When a woman has bacterial vaginosis then there are simple tests that you can perform in the surgery. There is something called the whiff test (although we do not use this very often) where you can put a drop of potassium hydroxide on some of the vaginal discharge and this will produce a very distinct odour if the patient has bacterial vaginosis. The more conventional way of testing is to take a high vaginal swab and send it to the lab. This can be accompanied by a PCR swab where the lab will look for Gardnerella and Trichomonas Vaginalis. For more information on these infections, please click here.

There are specialist clinics that get patients to send them samples from home. This is an extremely useful service for people who live in small communities and do not want to see their local doctor about matters that they consider highly personal. The problem with these sorts of services is that you get patients self-diagnosing and that brings with it all of the problems that I outlined above. There is one website that I have come across that has something called a symptom checker and it does direct people to the most appropriate test. You can find the website here. The only limitation is that the clinic does not have a huge range of options but they do instruct people to see their GP on the input of certain answers so I am quite confident that they have good intentions and the algorithm behind the symptom checker appears to be robust.

I have mentioned cervical cancer in this article and I do not want to be alarmist but an unusual discharge can be caused by abnormalities of the cervix. I strongly believe that these symptoms should not be ignored and I do offer to test patients for cervical cancer even if they do not fit the age profile normally associated with this disease. As a private doctor, I do not have the restrictions of a publicly funded health service so I can perform these tests. You can make an appointment with me from through this website. If you would like to read more about cervical screening, I recommend this website.

Happy Client

The view on Spenco Healthcare.

I am from such a minority community that is never recognized, it is so forgotten in almost all aspects especially health wise. But either way I want to thank you for your kind heart for building a health center in my community and keeping it up to standard so that we can get health services. Thank you
By
Charlotte B. Hosford
The Grey Whale Web Design Company

Happy Client

The view on Spenco Healthcare.

I am from such a minority community that is never recognized, it is so forgotten in almost all aspects especially health wise. But either way I want to thank you for your kind heart for building a health center in my community and keeping it up to standard so that we can get health services. Thank you
By
Marina A. Ruiz
The Large Fish Web Design Company